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May 16, 2020
New Phase Begins in COVID Crisis
It seems Maryland reached the peak in COVID-19 hospitalizations about a week ago. This was welcome news that Gov. Larry Hogan capped off this week by lifting our state’s stay-at-home order and replacing it, effective yesterday, with a “safer at home public health advisory.”

Hospitals across the state have acquitted themselves very, very well over the last two months. No small thanks go to all of you for your extraordinary efforts that made it look to outsiders as if we had it well in hand.
 
And we cannot fail to express sincere gratitude to our partners in government who’ve helped greatly. The MDH folks who helped create surge capacity and solve PPE shortages. The people at the Department of Education, who stood up child care for health care and other essential workers. The commissioners and staff at HSCRC who deployed our rate setting system to bolster hospitals’ finances.
 
But this crisis isn’t over, it’s just entering a new phase. Gov. Hogan has now begun to loosen restrictions on people’s movement and on economic activity. Marylanders will head to the beaches. Tourists will come in search of crabs. And many of us will venture back to retail shops and hair salons.

No doubt, even if people adhere to social distancing guidelines and cover their faces in public settings, Maryland will see an uptick in COVID-19 cases.
 
We in the hospital field must stay vigilant and ready to handle a possible new wave—and perhaps several more waves over the next year or longer. Those waves can be kept manageable, one hopes, with good contact tracing and better testing. But until there’s a vaccine in widespread use and effective drug therapies, hospitals will continue to receive plenty of COVID-19 patients. At the same time, we expect the number of patients having other needs to return to, or near to, pre-pandemic levels. 
 
You deserve congratulations for protecting Marylanders. Take just a moment to reenergize. Help your teammates regain their resilience. Welcome to the fourth inning.
Bob Atlas
President & CEO
Update on Remdesivir Distribution in Maryland
The first shipment of Remdesivir, a promising drug known to help coronavirus patients, was shipped Friday to most Maryland hospitals. In total, 108 10-day courses were distributed from this initial shipment. Maryland is expecting a larger shipment from the U.S. Department of Health and Human Services (HHS) in the coming days. Health Secretary Bobby Neal shared additional details in a letter to hospital executives Friday.
 
MHA continues to work with the Maryland Department of Health and HHS to obtain information about future allocations.
 
As a reminder, the next deadline for HHS-requested data to inform Remdesivir distribution is Monday (May 18) at 11:59 p.m. Hospitals should enter COVID confirmed and patients under investigation into Teletracking .
 
The American Hospital Association (AHA) advised that all hospitals should report at least the six admissions and ICU data fields into TeleTracking, even if they are using another reporting mechanism (e.g., National Healthcare Safety Network, or state reporting) for daily reporting. This is why Maryland’s hospitals need to complete these data fields once a week in Teletracking. For issues with accessing the portal or questions about the data, contact TeleTracking Technical Support at 1-877-570-6903.
 
Click here for specific instructions on the six data elements that need to be completed in TeleTracking.
 
AHA also advised that the supply of Remdesivir is limited. Over the next few weeks, HHS will allocate all of the donated supply from Gilead, and by early next week, approximately half of the available supply will have arrived for distribution (approximately 10% in the first allocation and 40% in the second allocation). Future allocations will be made over the next several weeks, but when the supply has been distributed, HHS anticipates that no more will be available in the U.S. until sometime after the end of August, at the earliest.
 
For more information, contact Nicole Stallings .
MHA Summary of All Issued CMS Emergency Waivers
MHA has reviewed all emergency 1135 waivers issued up to May 13 and created a summary document of those that are most pertinent to hospitals regarding alternative care sites, workforce, telehealth, discharge, and testing. MHA also compiled the original Centers for Medicare & Medicaid guidance from which these waivers were identified; members can access this package of materials here . MHA will work to update the waiver summary at appropriate times throughout the duration of the COVID public health emergency. For more information, contact Maansi Raswant .
Maryland Federal, State Leadership Thank Hospitals for National Hospital Week
To help recognize the hard work of hospital workers year-round, but particularly at this difficult time, MHA launched a #HeartsforHealthcareWorkers campaign for National Hospital Week. Thank you for engaging your teams and encouraging your communities to spread the love for hospital workers. The campaign included two videos featuring federal and state leadership thanking your employees. These were shared with your teams and via social media. Click the images below to view the videos or click here or here .
Gov. Hogan Issues Proclamation for National Hospital Week
Gov. Larry Hogan issued a proclamation Monday celebrating May 10-16 as National Hospital Week in Maryland. At MHA’s request, Gov. Hogan issued the proclamation in support of Maryland hospital workers, who are on the front line of the fight against COVID-19.

MHA shared the news here , here , and here , and Gov. Hogan shared the news on Twitter .
HSCRC Staff Recommends 3.5% All-Payer Revenue Growth
The Health Services Cost Review Commission (HSCRC) staff’s draft recommendation for the rate year 2021 annual update projects revenue growth of 3.5%—or 3.33% per capita. This includes adjustments to specific hospitals and net of adjustments for changes in uncompensated care and assessments. Excluding adjustments for uncompensated care and assessments and the set aside for unknown adjustments, the average hospital would receive a 3.22% revenue increase. Read more in this month’s edition of Newsbreak .
MHA Asks HSCRC to Consider 4 Principles in Guidance on Rate Year 2020 Undercharges
MHA shared four principals for the Health Services Cost Review Commission (HSCRC) to consider before offering final guidance on the rate year 2020 undercharges. In a letter to HSCRC Executive Director Katie Wunderlich , MHA suggests HSCRC consider:

  • Additional rate corridor relief based on each hospital’s unique circumstances, including relevant financial considerations, not just liquidity
  • Accounting for the CARES Act and other federal funding, with some limits
  • Retaining foundational global budgeted revenue incentive to avoid unnecessary utilization by adjusting prices
  • Recovering RY2020 undercharge, with reasonable rates, over the shortest possible period

MHA’s Council on Financial Policy will discuss next steps on May 19. For questions, contact Brett McCone .
Maryland Health Connection Opens Coronavirus Emergency Special Enrollment Period
Maryland Health Connection, the state’s health insurance marketplace, opened a Coronavirus Emergency Special Enrollment Period. This means that from now until June 15 any eligible Maryland resident can enroll in health coverage. This special enrollment is for private health plans only. People who are eligible for Medicaid can enroll any time of year. A Special Enrollment Toolkit is available to help spread the word. It includes:
  • One-click social media posts
  • Newsletter content in English and Spanish
  • HTML code to cut and paste and add a Maryland Health Connection button to your website
  • Consumer messaging

Blogs also are available in English and Spanish:
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Maryland Hospital Association | www.mhaonline.org